California DWC
Jul 1, 2024
CA OMFS Update: Physician Services (Q3 2024)
California’s Division of Workers’ Compensation (DWC) issued an update to the Physician and Non-Physician Practitioner portion of the Official Medical Fee Schedule (OMFS) for ...
Jun 28, 2024
Anthem's THM Network Closes, Stiffs Providers
Workers’ comp providers—in particular ancillary providers like physical therapists (PTs)—take note: if you have treated injured workers through Anthem’s Transparent Health Ma...
Jun 27, 2024
DWC MPN Meeting Accomplishes Nothing
Last week, California’s Division of Workers’ Compensation (DWC) held an informal stakeholder meeting to discuss its proposed changes to the regulations governing Medical Prov...
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Jun 25, 2024
Zurich - An Example of California's MPN Shell Game
Where opacity and obfuscation reign, injustice thrives. There may be no better example of this than California’s Medical Provider Network (MPN) system. T...
Jun 24, 2024
acūrrō Reprocesses Underpaid CA Bills
Sometimes, seeking correct reimbursement for treating injured workers doesn’t require a battle between providers and payers. Claims administrators and their vendors ca...
Jun 19, 2024
CA MPNs Harm Employers, Injured Workers & Providers
California’s Medical Provider Network (MPN) system is an unmitigated failure, causing genuine harm to injured workers, health care providers, and employers. The Divisi...
Jun 17, 2024
CA DWC: Claims Administrators' IBR Wingman
In California, claims administrators can expect little or no repercussions for failing to comply with workers’ comp payment laws and regulations. Meanwhile, the Divisi...
Jun 14, 2024
Sedgwick: 17,225 Audit Complaints Sent to DWC
Sedgwick Claims Management, Inc. continues to defy California law and regulations for properly responding to Second Review appeals. And why wouldn’t they, without any consequ...
Jun 10, 2024
Sedgwick Denies/Ignores Hundreds of Appeals
Sedgwick's persistent failure to pay providers in accordance with state workers' comp fee schedules and its refusal to respond compliantly to providers’ appeals are glaring v...
May 30, 2024
daisyData: CA e-EOR Most / Least Compliant Claims Admins
California mandates that all (repeat: all) workers’ comp claims administrators accept electronic bills from providers and respond to those e-bills with electronic Explanation...
May 16, 2024
CA DWC Website Deletions Enrich Claims Administrators
Given the complexity of workers’ comp (and the myriad ways claims administrators improperly deny requests for treatment and payment), knowledge is a precious resource for pro...
May 10, 2024
daisyBill Sends 13K+ Sedgwick Violations to CA DWC Director
Sedgwick’s consistent refusal to comply with California workers’ comp laws and regulations shows no signs of abating—in fact, it’s getting worse.Having been instructed...